Cellular Immunity Activation Method By Stimulating RD1 Complex Proteins as Virulence Marker on Mycobacterium tuberculum to Establish Diagnosis on Tuberculoss and Latent Tuberculosis Infection

This study was intended to invent a simpler and more affordable method to establish diagnosis on Tuberculosis (TB) and Latent Tuberculosis infection (LTBI). Similar to “Quantiferon TB Gold In Tube” (QFT-GIT) and T.SPOT.TB methods, the researchers also utilized “early secreted antigenic target 6kDa” (ESAT-6) and “cultur filtrate protein 10kDa” (CFP-10) proteins to be induced on the specimen. ESAT-6 and CFP-10 are commercial products used to induce interferon gamma (INF-γ) which were to be read using sophisticated and expensive equipment. This study was intended to conduct an analysis on effective cocktail protein modification, i.e. ESAT-6, CFP-10 and Ag85A/B/C, with high validity to detect cellular immunity activity through in vitro examination on peripheral blood monocyte cells of Tuberculosis-suspected patients or patients with latent tuberculosis infection. Peripheral Blood Monocyte Cells (PBMCs) activity on children tuberculosis patient or Latent Tuberculosis Infection (LTBI), adult tuberculosis patient or LTBI, which induced by cocktail protein modification and not induced, were analyzed microscopically. The activity of PBMCs on children and adult tuberculosis patient or LTBI induced by RD1 secretory proteins: ESAT-6, CFP-10, Ag85A/B/C was higher compared to PBMCs which had not been induced by the secretory proteins. Cellular debris and monocyte cells with abnormal shapes were found on PBMCs which had been induced by RD1 secretory proteins at 8 th day after culture

Progress In Knowledge Of Microscopic Tuberculosis Diagnosis Laboratory Training Participants

Indonesia is the second highest tuberculosis (TB)-burden country in the world. TB affects men and women in productive ages. Early and accurate diagnosis of TB is crucial in TB management because it allows prompt treatment with appropriate regimen. Sputum smear microscopy is the most common method used in resource-limited laboratories. The aim of this study is to assess whether adult learning method with student-centered approach can improve knowledge in laboratory techniques in microscopic TB diagnosis. It was a quasi experimental research with one group pretest and posttest design. Pretest was conducted before the training started. During the training, participants attended lectures, discussion sessions, and hands-on laboratory activities. After training, participants were asked to respond to posttest. There were 33 participants of this training (n=33). Paired t-test analysis showed significant difference between pretest and posttest scores (p=6.5x10-9). Variance between pretest scores was 4.00 and variance between posttest scores were 1.34. Pearson correlation coefficient was 0.45. Regardless their level of knowledge before training, participants could achieve relatively equivalent results after training. Significant difference between pre- and post-training test scores indicated that the learning method was effective and the training could improve participants knowledge in laboratory techniques in microscopic TB diagnosis

Clinical Profile and Treatment of Acne Vulgaris Patients

Background: Acne vulgaris (AV) is not a deadly condition may affect one’s quality of life. Treatment of AV includes topical and oral, depending on the severity. Antibiotics as oral treatment should not be given alone because it can precipitate resistance. Purpose: To describe the clinical characteristics of AV in a tertiary hospital in Indonesia and evaluate the treatment given. Methods: This is a descriptive, retrospective study with a cross-sectional design. The study subject was classified based on severity according to Plewig and Kligman’s acne grading. Further evaluation was made according to the type of lesion, the risk factortopical and oral treatment in subjects with grades 2, 3, and 4. This research was conducted at the Cosmetic Medic Division, Dermatology and Venereology Outpatient Clinic at Dr. Soetomo General Academic Hospital Surabaya based on medical records from the period of 2017 to 2019. Result: From 2017 to 2019, there were 525 (1.1%) new AV patients out of a total of 45,754 new patients. AV was the major diagnosis in the Cosmetic Medic division. AV grades 2, 3, and 4 were found in 167 patients (32.0%). The most common lesion was papulopustular (75.4%) and the most common risk factor was hormonal (58.7%). All the patients received tretinoin, clindamycin gel 1.2%, and sunscreen for topical treatment. Doxycycline was the most common oral antibiotic used (98.2%) Conclusion: The most common AV grade in this study was mild AV. Oral antibiotics were given to moderate-to-severe AV patients in combination with topical treatment to prevent resistance

The association between oral antibiotics with the decreased severity index of acne vulgaris in the medical cosmetics division dermatovenereology outpatient clinic of Dr. Soetomo General Teaching Hospital Surabaya from 2017- 2019

Abstract Background: Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit. AV therapy is given based on the severity of AV. Oral antibiotic therapy is routinely prescribed to treat moderate to severe inflammatory acne. The purpose of this study is to determine the relationship between systemic antibiotic administration and the decrease in the severity of acne vulgaris. Methods: This was a retrospective study with an analytical design, carried out on 49 medical records that met the inclusion criteria for acceptance of the sample; new AV patients come with grades 2, 3, and 4 to the Medical Cosmetics division Dermatovenereology Outpatient Clinic of Dr. Soetomo General Teaching Hospital Surabaya in the period January 2017 - December 2019. Results: This study was conducted on 49 patients with acne vulgaris grade 2,3,4 who came to follow-up in a week 2,4,8 treatment. Data from the first follow-up group, 26 subjects (53.1%) experienced a decrease in grade; from the second follow-up group, 25 subjects (51.0%) experienced a decrease in grade; from the third follow-up group, 38 subjects (77, 6%) experienced a decrease in the group comparing with condition patient before treatment. Analytic comparative showed that the condition of the first visit compared to the first, second and third follow-up groups were 0,180, 0,000, and 0,000, respectively. The significance test results showed a value of 0.000 (p ≤ 0.05) in the second and third follow-up groups, which is statistically significant. Conclusion: An oral antibiotic can effectively reduce the severity degree of acne vulgaris in four to eight weeks after treatment with an oral antibiotic

EKSPRESI GEN TRYPTOPHAN ASPARTATE COAT PROTEIN SEBAGAI BIOMARKER PENENTU STATUS INFEKSI PADA PASIEN TUBERKULOSIS

Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. Mycobacterium tuberculosis as a cause of tuberculosis disease is an intracellular pathogens that survives within the phagosome of host macrophages. Several host factors which are involved in this process, among others are typtophan aspartate containing coat protein (TACO). TACO is a protein recruited and retained by living Mycobacterium tuberculosis on the surface of the phagosome membrane to maintain its survival in phagosome, because the presence of TACO plays an important role in inhibiting the fusion of phagosomes and lysosomes. Several rapid tests to diagnose active tuberculosis cases, such as Tuberculin Skin Test (TST) and Interferon Gamma Releasing Assay (IGRA) only check the patient's immunological status but can not be used as a marker to differentiate the activity rate of tuberculosis infection.. Therefore, we hypothesized there was a difference in TACO expression on the surface of the phagosome membrane at the stage of TB infection. And we found that there was a significantly difference among the 5 groups of samples, there was a significantly difference from TACO protein expression between new TB patients and patients after 2 months of therapy, there was a significantly difference from TACO protein expression between new TB patients and patients after 5 months of therapy, there was no significantly difference from TACO protein expression among TB patients after 2 months of therapy with patients after 5 months of therapy, there was a significantly difference from TACO expression between new TB patients with latent tuberculosis (LTBI) infection patients, which is significantly from TACO expression in new TB patients with healthy people, there is a significantly difference from TACO expression in patients with latent tuberculosis (LTBI) infection with healthy people. However, when analyzed per group of samples and saw from the mean of each group, research results obtained from this study do not match with the existing theory that living Mycobacterium tuberculosis in the phagosome will retain TACO on the surface of the phagosome membrane. This fact is because of Mycobacterium tuberculosis may have other self-defense mechanisms, one of which is short interfering RNA (siRNA) which will interfere the mRNA target so that protein expression does not occur. So these results suggest that TACO protein can not be considered to be a biomarker in the determination of infection status in tuberculosis patients and monitoring treatment results of Anti Tuberculosis Drugs (OA

First-Line Anti-Tuberculosis Drug Resistance Pattern

Multidrug-resistant tuberculosis (MDR-TB) is a global public health crisis. Acid-fast bacilli (AFB) gradation in sputum examination is an important component in Pulmonary Tuberculosis (PTB) diagnosis and treatment outcome monitoring. Previously treated pulmonary TB patients with a higher AFB smear gradation may have higher rates of acquired resistance. Patients with a higher AFB grade indicate a higher bacillary load and had higher rates of acquired resistance. This study aims to evaluate the correlation between AFB gradation and first-line anti-TB drug resistance patterns in MDR pulmonary TB patients. This was a retrospective study conducted from August 2009 to April 2018 in Dr. Soetomo Hospital. Sputum samples were taken from MDR PTB patients. Sputum smear examination was done using Ziehl–Neelsen staining and gradation was measured according to IUATLD criteria. Samples with positive smear were evaluated for resistance patterns based on culture and resistance tests using the MGIT 960 BACTEC System. There were 433 sputum samples with AFB positive collected from MDR PTB patients. Resistance to RHES was found in 22 (14%) AFB +1, 19 (15%) AFB +2, and 29 (20%) AFB +3. Resistance to RHS was found in 22 (14%) AFB +1, 12 (9%) AFB +2, and 13 (9%) AFB +3. Resistance to RHE was found in 39 (25%) AFB +1, 38 (29%) AFB +2, and 35 (24%) AFB +3. Resistance to RH was found in 74 (47%) AFB +1, 61 (47%) AFB +2, and 69 (47%) AFB +3. Statistic analysis by Spearman test showed that there was no significant correlation between AFB gradation and first-line anti-TB drug resistance patterns. Acquired resistance to RHES can also found in lower bacillary load AFB +1

Penerapan Higiene dan Sanitasi Lingkungan pada Pasien Diare Balita di Puskesmas Surabaya

Surabaya has the most cases of diarrhea in East Java, with the highest detection targets in Gading Health Center (2346 cases) and Mojo Health Center, with diarrhea cases handled by 1322 cases. This study aimed to describe hygiene and environmental sanitation in under-five diarrhea patients in the working area of Surabaya Health Center. This study used a survey method, descriptive approach, interviews, and questionnaires in October 2019-March 2020. The results showed 62,2% of under-fives ‘drinking water sources were ineligible, 86,5% of mothers’ handwashing behavior were ineligible, 67,6% of the use of serving hoods were ineligible, 100% of food ripeness level were eligible, 59,5% of the distance between well and septic tank were eligible, 100% of latrines were eligible, 89,2% of sewerages were ineligible, and 83,8% of waste disposal facilities were ineligible. This research concluded that drinking water sources, handwashing behavior, serving hoods, sewerages, and waste disposal facilities were ineligible. The problems can be solved by consuming branded gallons of water / well water or refillable water that is boiled before consumption, improving how to wash hands with soap and running water, covering food using a serving hood, use the cover to close the sewerage, and throwing the trash into the temporary shelter (TPS) as much as two times a week or less than 3x24 hours.Kota Surabaya memiliki kasus diare terbanyak di Jawa Timur dengan target penemuan terbanyak di Puskesmas Gading sebanyak 2346 kasus dan Puskesmas Mojo dengan kasus diare ditangani sebanyak 1322 kasus. Tujuan penelitian ini adalah mengetahui gambaran higiene dan sanitasi lingkungan pasien diare balita di wilayah kerja Puskesmas Surabaya. Penelitian ini menggunakan metode survei, pendekatan deskriptif, wawancara dan kuesioner pada bulan Oktober 2019-Maret 2020. Hasil penelitian menunjukkan 62,2% sumber air minum balita tidak memenuhi syarat, 86,5% perilaku cuci tangan ibu tidak memenuhi syarat, 67,6% penggunaan tudung saji tidak memenuhi syarat, 100% kematangan makanan memenuhi syarat, 59,5% jarak sumur dengan septic tank memenuhi syarat, 100% jamban memenuhi syarat, 89,2%, saluran pembuangan air limbah tidak memenuhi syarat, dan 83,8% sarana pembuangan sampah tidak memenuhi syarat. Simpulan penelitian ini adalah sumber air minum, perilaku cuci tangan, penggunaan tudung saji, saluran pembuangan air limbah, dan sarana pembuangan sampah masing- masing tidak memenuhi syarat. Permasalahan tersebut dapat diatasi dengan mengonsumsi air galon bermerk/air sumur atau air isi ulang yang direbus sebelum dikonsumsi, memperbaiki cara mencuci tangan dengan sabun dan air mengalir, menutup makanan dengan tudung saji, memasang penutup untuk saluran pembuangan air limbah, dan membuang sampah ke TPS sebanyak 2 kali dalam seminggu atau kurang dari 3x24 jam. &nbsp

The Antibacterial Effect of Ethanol Extract of Garlic (Allium sativum L.) on Methicillin Resistant Staphylococcus aureus (MRSA) In Vitro

Objective: To determine the antibacterial activity of ethanol extract of garlic against Methicillin-Resistant Staphylococcus aureus. Method: Dilution test was performed on 9 different concentration of ethanol extract of garlic (1024, 512, 256, 128, 64, 32, 16, 8, 4 mg/mL) dissolved in DMSO 10% and MRSA suspension on Mueller Hinton broth medium to determine the Minimum Inhibitory Concentration. The Minimum Bactericidal Concentration was determined by the result of streaking of MRSA inoculation on the nutrient agar plate. Results: The observation through Mueller Hinton broth medium has shown turbidity both before and after incubation because of garlic ethanol extract color which is blackish-brown and thick, while in the nutrient agar medium, MRSA bacteria grew on the media with concentrations 4, 8, 16, 32, 64, & 128 mg/mL and unable to grow at concentrations of 256, 512, and 1024 mg/mL. Conclusion: The MIC of ethanol extract of garlic on MRSA could not be determined, and the MBC in this study was 256 mg/mL

Biofilm Formation By The Interaction Of Fungi (Candida Tropicalis) With Various Bacteria

Biofilms are composed of more than one species and are often called polymicrobial biofilms, so research is needed on the formation of polymicrobial biofilms, especially between fungi and bacteria. This study aimed to analyze the total biomass and metabolic activity of biofilms formed from the interaction of fungi (Candida tropicalis) with various bacteria, including Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. Bacterial and fungal cultures were suspended in tryptic soy broth (TSB) medium, and biofilm was cultivated in two 96-well microplates for 48 hours at 37°C. The crystal violet assay was used to detect the total biomass biofilm, and the tetrazolium salt (3-(4,5-dimethylthiazol-2-yl)-2,5diphenyltetrazolium bromide, or MTT) Assay was used to obtain the metabolic activity of biofilm with the optical density (OD) value using an ELISA reader. The results of this study obtained significant data from both parameters. The highest average value was found in the C. tropicalis treatment group (2,412 ± 0.825 on the biomass test results; 1,525 ± 0.473 on the metabolic activity test results), while the lowest was seen in the S. aureus treatment group (0.512 ± 0.224 in the biomass test results; 0.978 ± 0.349 in the metabolic activity test results). In conclusion, it was confirmed that biofilm biomass could be generated strongly in each treatment in the total biomass parameter, while metabolic activity data suggested that each treatment could carry out cell proliferation